Hemifacial Spasm: Occurrence in Multiple Sclerosis

Telischi, Fred F.; Grobman, Lawrence R.; Sheremata, William A.; Apple, Marc; Ayyar, Ram

doi:10.1001/archotol.1991.01870170100022

Cited by 27 publications

(15 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…HFS has been well documented in patients with multiple sclerosis. In 2 patients the plaques were found in the area of the facial nucleus on the involved side, supporting a central (brain stem) origin of HFS 52. In another series, 5 of 733 patients had HFS associated with multiple sclerosis 53.…”

Section: Discussionmentioning

confidence: 86%

The many faces of hemifacial spasm: Differential diagnosis of unilateral facial spasms

2011

View full text Add to dashboard Cite

Hemifacial spasm is defined as unilateral, involuntary, irregular clonic or tonic movement of muscles innervated by the seventh cranial nerve. Most frequently attributed to vascular loop compression at the root exit zone of the facial nerve, there are many other etiologies of unilateral facial movements that must be considered in the differential diagnosis of hemifacial spasm. The primary purpose of this review is to draw attention to the marked heterogeneity of unilateral facial spasms and to focus on clinical characteristics of mimickers of hemifacial spasm and on atypical presentations of nonvascular cases. In addition to a comprehensive review of the literature on hemifacial spasm, medical records and videos of consecutive patients referred to the Movement Disorders Clinic at Baylor College of Medicine for hemifacial spasm between 2000 and 2010 were reviewed, and videos of illustrative cases were edited. Among 215 patients referred for evaluation of hemifacial spasm, 133 (62%) were classified as primary or idiopathic hemifacial spasm (presumably caused by vascular compression of the ipsilateral facial nerve), and 4 (2%) had hereditary hemifacial spasm. Secondary causes were found in 40 patients (19%) and included Bell's palsy (n=23, 11%), facial nerve injury (n=13, 6%), demyelination (n=2), and brain vascular insults (n=2). There were an additional 38 patients (18%) with hemifacial spasm mimickers classified as psychogenic, tics, dystonia, myoclonus, and hemimasticatory spasm. We concluded that although most cases of hemifacial spasm are idiopathic and probably caused by vascular compression of the facial nerve, other etiologies should be considered in the differential diagnosis, particularly if there are atypical features.

show abstract

Section: Discussionmentioning

confidence: 86%

The many faces of hemifacial spasm: Differential diagnosis of unilateral facial spasms

2011

View full text Add to dashboard Cite

show abstract

“…This male-to-female ratio corresponds closely with the ratio observed in this referral-based series, as well as by others. 18,30,35,38,40 The incidence of these diseases in association with hemifacial spasm is unknown, but is most probably small. 9,20 Also in agreement were the percentage of patients with onset of symptoms elsewhere than in the orbicularis oculi, with associated trigeminal neuralgia, and with symptoms of contralateral hemifacial spasm.…”

Section: Discussionmentioning

confidence: 99%

Microvascular decompression for hemifacial spasm

Barker¹,

Jannetta²,

Bissonette³

et al. 1995

Journal of Neurosurgery

390

200

View full text Add to dashboard Cite

The authors report the results of 782 microvascular decompression procedures for hemifacial spasm in 703 patients (705 sides), with follow-up study from 1 to 20 years (mean 8 years). Of 648 patients who had not undergone prior intracranial procedures for hemifacial spasm, 65% were women; their mean age was 52 years, and the mean preoperative duration of symptoms was 7 years. The onset of symptoms was typical in 92% and atypical in 8%. An additional 57 patients who had undergone prior microvascular decompression elsewhere were analyzed as a separate group. Patients were followed prospectively with annual questionnaires. Kaplan-Meier methods showed that among patients without prior microvascular decompression elsewhere, 84% had excellent results and 7% had partial success 10 years postoperatively. Subgroup analyses (Cox proportional hazards model) showed that men had better results than women, and patients with typical onset of symptoms had better results than those with atypical onset. Nearly all failures occurred within 24 months of operation; 9% of patients underwent reoperation for recurrent symptoms. Second microvascular decompression procedures were less successful, whether the first procedure was performed at Presbyterian-University Hospital or elsewhere, unless the procedure was performed within 30 days after the first microvascular decompression. Patient age, side and preoperative duration of symptoms, history of Bell's palsy, preoperative presence of facial weakness or synkinesis, and implant material used had no influence on postoperative results. Complications after the first microvascular decompression for hemifacial spasm included ipsilateral deaf ear in 2.6% and ipsilateral permanent, severe facial weakness in 0.9% of patients. Complications were more frequent in reoperated patients. In all, one operative death (0.1%) and two brainstem infarctions (0.3%) occurred. Microvascular decompression is a safe and definitive treatment for hemifacial spasm with proven long-term efficacy.

show abstract

“…Ballism can occur as hemiballism, monoballism or biballism, but MS still is a very rare etiology for ballism [8][9][10][11][12][13][14][15][16][17] . Hemifacial spasm is considered an extremely rare MD manifestation in patients with MS. Hemifacial spasm is possible due to lesions of MS in the brainstem, but only few case reports have described this MD in MS patients 18 . The concomitance of ballism and tremor was previously described, as rare MS presentation, but others MD association which could result in CHMD in the secondary progressive MS patient, similar our case, has yet not been reported 15,16 .…”

Section: Discussionmentioning

confidence: 99%

Complex hyperkinetic movement disorders: an unusual presentation in multiple sclerosis

Kay

Scola

Lorenzoni

et al. 2009

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Movement disorders (MD) in patients with multiple sclerosis (MS) has been few reported. The most common MD associated with MS are tremor and dystonia, but parkinsonism, myoclonus, chorea, ballism, paroxysmal dyskinesias and hemifacial spasm have been more rarely found in MS patients 1,2 . Complex hyperkinetic movement disorders (CHMD) is the term used to describe patients who present concomitantly more than one type of MD, although there is not always consensus as to the type of motor symptomatology 3 . We report on the first case of CHMD in a Brazilian patient with MS. CaseA 21-year old woman presented with acute left facial paresis and weakness in right upper limb. At age 27, she developed a sudden episode of visual loss, dysphagia, dysarthria, dizziness, incoordenation, loss of balance, weakness in left lower limb and gait difficulty. The diagnosis of MS relapse was made (EDSS score was 5.0), brain magnetic resonance imaging (MRI) demonstrated demyelinating abnormalities which fulfill the criteria for MS, and after treatment with intravenous methylprednisolone the symptoms partially remitted.However, during the following two years she presented progressive visual loss, weakness and postural instability associated to incapacitating involuntary movements, which restricted her to wheelchair (EDSS score was 8.0), despite treatment with interferon beta-1a (44 µg tiw). Neurological examination showed nystagmus; anarthria; facial paresis; muscle strength 4 in upper limbs and 3 in lower limbs (MRC score); arms and legs spasticity; brisk reflexes in the right leg; bilateral Babinski's sign; and CHMD characterized by no rhythmic tremor at rest (frequency of 3-4 Hz) which intensified during action in upper limbs (predominantly left), lower limbs (particularly in left) and jaw, cervical dystonia (spasmodic torticollis), ballistic movements in upper limbs, and left hemifacial spasms.The clinical features were thought to be consistent with secondary progressive form of MS and treatment with mitoxantrone was started (total dose of 80 mg for 9 months) which no reduce her disease progression (EDSS score was 9.5 after one year).

show abstract

Hemifacial Spasm: Occurrence in Multiple Sclerosis

Cited by 27 publications

References 19 publications

The many faces of hemifacial spasm: Differential diagnosis of unilateral facial spasms

The many faces of hemifacial spasm: Differential diagnosis of unilateral facial spasms

Microvascular decompression for hemifacial spasm

Complex hyperkinetic movement disorders: an unusual presentation in multiple sclerosis

Contact Info

Product

Resources

About